Individual
CASEY RAE DE VITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8626 AIRWAYS BLVD, SOUTHAVEN, MS 38671-2603
(662) 772-5937
(662) 772-5940
Mailing address
333 COUNTY ROAD 108, WATER VALLEY, MS 38965-3911
(601) 341-3633
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
3238
MS
Other
Enumeration date
04/03/2025
Last updated
07/14/2025
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